In recognition of the persistent and increasing challenges in attracting and retaining physician investigators (PIs) in academic medical schools and other research venues, there is widespread agreement within the biomedical research community that there needs to be renewed assessment of the factors that threaten this critically important career pathway as well as the development of ways to revitalize the PI workforce. Association of Professors of Medicine (APM) and Association of Specialty Professors (ASP) held a series of conferences resulting in published and disseminated recommendations to expand the pool of funds to retain and foster the careers of young scientists; improve the approach to mentorship of young investigators; promoting the advancement of women scientists; and identify and foster the career development of future scientists (medical and undergraduate university students). In response to growing concerns about existing NIH support for physician scientists, Director Francis Collins charged a Physician Scientist Workforce Working Group to assess the current mechanisms of career support and make recommendations for improvement. In June, 2014, the Working Group issued their report with a series of recommendations which urged the NIH to sustain strong training of MD PhDs; shift the balance in postdoctoral training for physicians; continue to address the gap in award rates between new and established investigators; and adopt rigorous tools to assess the strength of the biomedical workforce including PIs. With the goal of stimulating a vigorous, ongoing national dialog on the factors which threaten the physician investigator workforce, the Alliance for Academic Internal Medicine (AAIM) Board of Directors endorsed the development of Third Consensus Conference on the PI Workforce, entitled Re-examining the Physician Investigator Workforce: New and Evolving Areas of Research and Pathways to Success in Academic Institutions. This R13 application looks to leverage AAIM support to expand the discussion and dialog surrounding the physician investigator workforce. The aims of this conference are to assess the current environment in which academic medical centers develop the careers of PIs, and to seek innovative solutions (beyond federal funding) to overcome existing challenges so as to maintain and expand a vigorous workforce.